An unusual cause of heart failure

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Pelvic arteriovenous malformations (AVMs) are uncommon entities that can present with symptoms resulting from compression of adjacent structures, ischemia due to ‘steal phenomenon’ or, rarely, heart failure. We present a case of heart failure in a patient who presented to our facilities for heart transplant and a prior diagnosis of idiopathic dilated cardiomyopathy; further evaluation revealed a massive pelvic AVM as causative for the heart failure. This case emphasizes the importance of a thorough physical examination to guide appropriate diagnostic testing.

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